Estimation of gestational age using trans-cerebellar diameter: a sonographic study of a cohort of healthy pregnant women of Igbo ethnic origin in a suburb of Lagos, southwest Nigeria.

AIM: To use a sonographic method to determine the usefulness of trans-cerebellar diameter (TCD) as an independent estimator of gestational age (GA). METHODS: A convenience sample of 257 healthy pregnant women of Igbo ethnic origin with singleton normal pregnancy whose GA ranged from 16 to 40 weeks were examined. GA was calculated from the date of onset of the last menstrual period (LMP) and was used as the standard criterion, while the biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) were used to estimate GA. TCD was measured and employed to derive regression models utilized to assess GA. RESULTS: The mean TCD was 32.0 ± 11.6 mm; TCD had a strong positive linear relationship with GA (R = 0.988; R2 = 0. 975; P = < 0.001). The GA that was estimated using regression models, which were derived using the sonographically measured TCD, was closer to the actual GA in the second and third trimesters of pregnancy than the GA estimated using other fetal parameters. CONCLUSION: In a population of healthy pregnant women of Igbo ethnic origin living in Oshodi, Lagos State, Nigeria, the sonographically measured TCD was more accurate as a single estimator of GA than BPD, HC, AC, and FL in the late stages of pregnancy. Subject to further validation, the nomograms derived using TCD proposed in the present study could be used as reliable GA estimators in the late stages of pregnancy among women who are unsure of the date of onset of their LMP.

Sonographic evaluation of kidney echogenicity and morphology among HIV sero-positive adults at Lagos University Teaching Hospital.

AIM: To evaluate the role of kidney echogenicity and morphology in the diagnosis of human immunodeficiency virus-associated nephropathy (HIVAN). SUBJECTS AND METHODS: In the cross-sectional study, a sample of 340 anti-retroviral therapy (ART)-naïve AIDS patients underwent laboratory CD4+ count, serum creatinine determination and sonographic renal echogenicity grading and size measurement. Rounded kidneys were described as bulbous while bean-shaped kidneys were described as reniform; echogenicity was categorized into grades 0, 1, 2 and 3. Kidney length, width, thickness and volume were measured in HIVAN and control groups. RESULTS: Mean age of the population was 42.7 ± 9.4 years; 87.4% had HIVAN. Mean CD4+ count, serum creatinine and GFR for HIVAN patients were 153.1 ± 103.2 cells/mm3, 218.4 ± 147.4 mmol/L and 50.1 ± 23.6 mL/min/1.73 m2 for males and 121.9 ± 91.0 cells/mm3, and 222.0 ± 150.4 mmol/L and 39.3 ± 20.6 mL/min/1.73 m2 for females, respectively; control subjects and non-HIVAN patients had grade 0 renal echogenicity; 56.9% of HIVAN patients had echogenicity grade 3; 5.3% had kidney length < 10 cm; 73.9% had bulbous kidneys; the kidney was significantly wider and thicker in HIVAN (p < 0.05). CONCLUSION: Sonographic evaluation of renal echogenicity and morphology can reliably predict HIVAN diagnosis. Apathy to screening and late presentation were high while HIV/AIDS remains an important public health problem in the city of Lagos. Unilateral reduction in kidney size could be a major sequela of AIDS while sonographic measurement of absolute kidney length appears inadequate in the evaluation of AIDS patients with nephropathy.

Reliability of Sonographic Estimation of Fetal Weight: A Study of Three Tertiary Hospitals in Nigeria.

CONTEXT: There is a dearth of sonologists in Nigeria, yet sonographic estimation of actual birth weight (ABW) is important in antenatal care. AIM: To determine the reliability of estimated fetal weight (EFW) by sonographers and sonologists in Lagos Nigeria. SETTINGS AND DESIGN: In the cross-sectional study, a convenience sample of 663 healthy women with singleton pregnancy at term was selected. Ethical approval for the study design and consent of participants were obtained. SUBJECTS AND METHODS: Three sonographers and three sonologists used a single ultrasound scanner with Hadlock-3 algorithm to measure biparietal diameter, abdominal circumference, and femur length in three centers while three midwives used a single neonatal weighing scale to measure ABW. STATISTICAL ANALYSIS USED: Medical® statistical software version 12.5 was used to analyze data. Descriptive and inferential statistics, as well as Bland/Altman plots were used to determine reliability of EFWs. Results were tested for statistical significance at P ≤ 0.05. RESULTS: Majority (76.2%) of babies had normal weight while mean EFW and ABW were 3.50 ± 0.10 kg and 3.45 ± 0.12 kg, respectively and the difference between them is not statistically significant (P > 0.05). For sonographers and sonologists in each center, mean error and coefficient of variation were very small while Pearson's correlation coefficient as well as intra- and interclass correlation coefficients was very high. CONCLUSION: Independent estimation of ABW by sonographers in Lagos metropolis was very reliable. Sonography was also highly reliable in predicting macrosomia.

Correlation of ultrasonographic estimated fetal weight with actual birth weight in a tertiary hospital in Lagos, Nigeria.

BACKGROUND: Sonographic fetal weight estimation is an important component of antenatal care. AIM: To sonographically estimate fetal weight at term and to compare estimated with actual birth weights to determine the validity of estimated fetal weights. SUBJECTS AND METHODS: In the prospective study, a convenience sample of 282 women was recruited. Ethical approval and informed consent of patients were obtained. An experienced sonographer estimated fetal weights by measuring BPD, HC, AC and FL using a scanner with Hadlock 3 weight estimation model. Actual birth weights were measured with a Crown weighing scale by a midwife. Data was analyzed with SPSS software version 17.0 while descriptive and inferential statistics were used to interpret results. Results were tested at error level set at p≤ 0.05. RESULTS: Mean estimated and actual birth weights were 3378±40g and 3393±60g respectively. Difference between the two means was not significant. Eleven percent of fetuses were sonographically estimated to be microsomic while 14.5% were microsomic at birth; 12.1% were sonographically estimated to be macrosomic but 15.2% were macrosomic at birth. Most macrosomic fetuses were delivered through cesarean section(CS) and fetal weights increased with maternal age and parity. CONCLUSION: Sonographically estimated fetal weight using Hadlock 3 weight estimation model without validation correlated positively with actual birth weight in a Nigerian population.

CT-detected intracranial hemorrhage among patients with head injury in Lagos, Nigeria.

PURPOSE: To evaluate the computed tomography (CT) findings of intracranial hemorrhage among patients with head trauma in Lagos, Nigeria. METHODS: In this retrospective, cross-sectional study, a convenience sample of 500 patients with head trauma who had diagnostic cranial CT scans was selected. All the radiological reports and CT scans of patients with head trauma were retrieved in the hospitals selected as study sites. The reports were sorted into 2 groups - normal findings and intracranial bleeding. The reports of intracranial bleeding were sorted again into different classes of intracranial bleeding as identified by the radiologist who reported it. All data were analyzed using the Epi Info public domain software package. The chi-square test was used to measure the statistical significance of study results at P < .05. RESULTS: Most of the study subjects (68%) were men. Traffic accidents accounted for 44% of all the head traumas found in the study, and 58% of the head traumas resulted in intracranial bleeding. Among the hemorrhages found, 37% were intracerebral, 25% were subdural, 16% were intraventricular, 15% were subarachnoid, and 7% were epidural. DISCUSSION: Intracranial hemorrhage was a common consequence of acute head trauma sustained from traffic accidents in the population studied, with intracerebral hemorrhage being the most prevalent type. CONCLUSION: Traffic accidents are the main cause of acute head trauma in Lagos, Nigeria. The use of CT for early diagnosis of intracranial hemorrhage appears justifiable.

Ultrasonographic kidney sizes among children in Benin, Nigeria: correlation with age and BMI.

PURPOSE: To determine kidney sizes among Nigerian children using ultrasonography to provide local reference data that could be compared with renal growth charts when assessing kidneys of Nigerian children for growth or pathology. METHODS: The study design was cross-sectional and a convenience sampling technique was used to select a sample. Consent was obtained from participants and ethical approval was obtained from the local ethics committee. A DP-1100 sector scanner with a 3.5 MHz probe was used for the study. Sonographers measured kidney length, width, and thickness and calculated renal volume. Renal sizes were correlated with somatometric parameters. Regression equations were derived for each pair of variables. RESULTS: No statistically significant difference was found in kidney sizes between male and female participants or between length, width, or volume of right and left kidneys. A strong correlation was found between kidney length and volume and the participant's age and body mass index. CONCLUSION: This study has provided values of kidney sizes in a normal Nigerian pediatric population. Regression equations also were derived for easy computation of kidney sizes.

Assessment of radiation protection practices among radiographers in Lagos, Nigeria.

BACKGROUND: Use of ionising radiation in diagnostic radiography could lead to hazards such as somatic and genetic damages. Compliance to safe work and radiation protection practices could mitigate such risks. The aim of the study was to assess the knowledge and radiation protection practices among radiographers in Lagos, Nigeria. MATERIALS AND METHODS: The study was a prospective cross sectional survey. Convenience sampling technique was used to select four x-ray diagnostic centres in four tertiary hospitals in Lagos metropolis. Data were analysed with Epi- info software, version 3.5.1. RESULTS: Average score on assessment of knowledge was 73%. Most modern radiation protection instruments were lacking in all the centres studied. Application of shielding devices such as gonad shield for protection was neglected mostly in government hospitals. Most x-ray machines were quite old and evidence of quality assurance tests performed on such machines were lacking. CONCLUSION: Radiographers within Lagos metropolis showed an excellent knowledge of radiation protection within the study period. Adherence to radiation protection practices among radiographers in Lagos metropolis during the period studied was, however, poor. Radiographers in Lagos, Nigeria should embrace current trends in radiation protection and make more concerted efforts to apply their knowledge in protecting themselves and patients from harmful effects of ionising radiation.